What does Medicare cover?

Hospitalization includes semiprivate room and board, general nursing and other hospital services and supplies. Also covered, up to 90 days inpatient healthcare in an approved psychiatric hospital.

The amount of Medicare coverage for hospitalization is based on the following benefit periods:

Benefit

Medicare pays

You Pay

First 60 days

All but $1,288

$1,288

61st to 90th day

All but $322 a day

$322 a day

91st to 150th day*

All but $644 a day

$644 a day

Beyond 150 days

Nothing

All costs

* 60 reserve days may be used only once.

Skilled Nursing Facility Care

You must have been in a hospital for at least three days, enter a Medicare-approved facility generally within 30 days after hospital discharge and meet other program requirements. Medicare coverage for skilled nursing facility care is based on the following benefit periods:

Hospice care includes drugs for symptom control and pain relief, medical and support services from a Medicare-approved hospice, and other services not otherwise covered by Medicare. Hospice care is usually given in your home.

Benefit

Medicare pays

You Pay

For as long as doctor certifies need

All but limited costs for outpatient drugs and inpatient respite care

Limited cost sharing for outpatient drugs and inpatient respite care

Blood

Blood services are included when furnished by a hospital or a skilled nursing facility during a covered stay.

Benefit

Medicare pays

You Pay

Unlimited during a benefit period if medically necessary

80% of the Medicare-approved cost after the first 3 pints per calendar year

100% of the first 3 pints then 20% of the approved cost of additional pints*

* To the extent the three pints of blood are paid for or replaced under one part of Medicare during the calendar year, they do not have to be paid for or replaced under the other part.